Angels of mercy

It appears that Canada has experienced a visitation from an “angel of mercy”, a media euphemism for a medical serial killer. Arrested this week, Elizabeth Wettlaufer allegedly killed eight patients in Ontario nursing homes since 2007. The Canadian media is describing her as one of Canada’s worst serial killers.

She faces stiff competition in other countries. In Italy, Daniela Poggiali, a nurse, was sentenced earlier this year over 13 deaths. In the US, Charles Cullen, a nurse. was sentenced in 2006 over the deaths of about 40 patients. In Germany Stephan Letter killed at least 29 patients in 2003 and 2004. And then there is Dr Harold Shipman, the quiet English doctor who killed 250 patients.

These horrors never seem to be mentioned when the legalization of euthanasia is being debated, but they should be. The existence of these mad “angels of mercy” demonstrates that some healthcare professionals feel compelled to kill the defenceless people entrusted to their care.

Legalisation creates a class of people who do the same thing but without the secrecy. In Belgium and the Netherlands, the bulk of the euthanasia business seems to be carried out by a handful of doctors. Some of them have killed scores of patients. What does that do to them? Why do they volunteer? Will there be more “angels of mercy” in jurisdictions where euthanasia is legal? These are all questions that need to be asked and answered. 

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We goofed. Sorry

We goofed and we're eating humble pie. Wednesday, October 19, was World Bioethics Day. I'm afraid that it passed unnoticed at BioEdge, perhaps because every day is World Bioethics Day here. But was also the first time it was celebrated, so we shall be better prepared next year.

However, it appears that very few people were popping champagne bottles in the UK and US even though they must have the larges number of bioethicists. No events were planned in the United Kingdom, only one in the US, and 29 in India. World-wide, there were events in 55 countries, most on the theme of the Day, "human dignity and human rights". 

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Remembering Tanonius Marcellinus, a fun guy to be with

In the 19th Century a statue of Tanonius Marcellinus, consul of Campania (now the region around Naples) was unearthed in the town of Benevento. It bore a remarkable inscription, one which may be unique in the history of Western Civilization. It described him as a “most worthy patron, on account of the good deeds which rescued the population from endless boredom”.

Boredom -- taedium in Latin -- will soon be a reason to be euthanised in the Netherlands, as we report below. Of course it won’t be a spur of the moment decision. There will be a bit of boring paperwork to fill out first and some boring interviews to be endured, but in the end you get your needle.

It’s hard to understand why Dutch politicians think that this is a good thing. The worthy consul Tanonius Marcellinus was memorialized for rescuing his people from boredom with good deeds, not with lethal injections. Isn’t that the proper role of governments: to foster a society in which people feel glad to be alive? 

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A world without Down’s?

British actress Sally Phillips has made a magnificent documentary about Down Syndrome for the BBC. (You can watch it here on a legally dodgy YouTube link.) Her own son Ollie has Down Syndrome and Ms Phillips is convinced that Ollie has been a jolly good thing for her and her family. It grieves her to see that most mothers treat a diagnosis of Down Syndrome as a catastrophe. In the UK about 90% of women abort their Down Syndrome child after screening; in Iceland 100% of mothers do. That's 100%.

Ms Phillips tells the camera, as she chokes back tears, “The type of characteristics that these people share are so benign. It’s like when the Western explorers encountered the dodo. This nice, curious bird comes up and gets … wiped out. Through not being suspicious enough. Or violent enough.” This makes her concerned about what the Brits call NIPT (non-invasive pre-natal testing) which is being rolled out across the country.

The documentary is unashamedly emotional. That’s the way it should be. Thank God somebody has the courage to feel emotional about Down Syndrome people. I started to get angry when I read a scathing review in the New Statesman dismissing the doco as “profoundly anti-choice”. But there’s no point in being angry with someone whose attachment to an ideology blinds them to the splendour of being human. 

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What can be done about Duterte?

Yes, the American president is the most powerful man in the world. Yes, he has the launch codes. But there is something unhealthy in the preoccupation of the world’s media with the US presidential campaign at the expense of other world trouble spots.

Donald Trump, who must be the worst major party candidate ever, seems to have incited violence at some of his rallies and has even made vague threats to Hillary Clinton. If you Google “Trump violence”, you will get 82,700,000 results. It’s a live issue, at least in the media.

Google “Duterte violence” and you will get only 971,000 results – about 1% of the figures for Trump. But Mr Duterte has incited thugs, vigilantes and police to kill drug dealers and since he took office on June 30. The Filipino president now has the blood of 3,500 of his own countrymen on his hands. And he is not a buffoon running for President. He is the President.

But it could get worse. This week he cheerfully compared himself to Hitler. “Hitler massacred three million Jews ... there’s three million drug addicts. There are. I’d be happy to slaughter them,” he told a press conference. “You know my victims. I would like (them) to be all criminals to finish the problem of my country and save the next generation from perdition.”

The number of murders in July, August and September is more or less equivalent to the number of civilians killed in Syria. Why doesn’t the world care? It’s probably because Duterte’s victims are drug addicts and dealers. Even if they are, they have a right to life and a right to justice. They are human beings; they are not scum.

The world is demanding the removal of Syria’s President Assad because of the atrocities committed by his regime. It’s time that world leaders called for the removal of President Duterte. 

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Blood ties

Csanad Szegedi receiving tuition

One of the recurring themes thrown up by assisted reproduction is the importance of genetic ties. Are we determined by our origins, or can we forge our own identity? Does it matter whether our nearest and dearest are our kith and kin or whether they are just the people we hang around with?

By chance I just stumbled across the astonishing story of a Hungarian politician whose life was transformed when he discovered his true genetic identity.

By the time Csanad Szegedi was 24, he was vice-president of Jobbik, a far-right, nationalist and virulently anti-Semitic party. He was elected to the European Parliament as a Jobbik MEP in 2009 and wrote a book, I Believe in Hungary’s Resurrection.

Then he learned his family’s deepest secret: he was a Jew. His grandfather and grandmother were actually Auschwitz survivors.

Szegedi’s life fell apart. He was forced to resign from Jobbik.

Suddenly he did a complete about-face. Under the tuition of a Lubavitch rabbi from New York who was living in Budapest he became an Orthodox, observant Jew; he had himself circumcised, adopted the name Dovid and burned a thousand copies of his book. Now he is migrating to Israel with his wife and two children. He is interesting in joining the Knesset.

Szegedi is obviously a complex, intense man. He could even be a charlatan. But his astonishing journey does suggest that there is something to the idea that our personal identity is incomplete if it lacks the genetic heritage. 

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Belgian euthanasia and nihilism

Today is a landmark, of sorts. It marks the first time that a child has been euthanised under contemporary euthanasia laws. Of course, euthanising infants is relatively common, but not children who are old enough to be asked if they really want to die. The death occurred last week in the Flemish-speaking part of Belgium, although it was announced today by Belgium's euthanasia supremo, Wim Distelmans. His words were very sober and solemn, as befits the occasion, but I suspect that he and his colleagues are quietly happy to see the boundaries of euthanasia spread even further.

Ultimately this is a triumph for out-and-out nihilism, not just Belgium's inventive euthanasia lobby. Nihilism is a philosophical fad which seems to catching on. Below we feature a report on three American bioethicists who argue the case for population control to fight climate change and a defense of infanticide by a Finnish bioethicist. I've also just discovered a new book by South African philosopher David Benatar. In it he argues that procreation is morally wrong because life's a bitch and then you die (I am over-simplifying, of course.) He concludes his book with these cheerful thoughts: 

Every birth is a future death. Between the birth and the death there is bound to be plenty of unpleasantness ... Inflicting serious harm—or even the risk of it—on one person, without his or her consent, in order to benefit others, is presumptively wrong. 

If I'm right, euthanising a child is not an terminus for Belgian euthanasia, but just a bus stop en route to pure nihilism. What its supporters are trying to eliminate is not just pain, but life itself. What do you think? 

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Excel glitch

I’m not very clever with spreadsheets. Never have been. Never will. My consolation, though, is that some people who use them 24/7 may not be either. A study by Australian researchers in the journal Genome Biology found that 20% of genomic papers contain errors because of a simple conversion error in the popular program Microsoft Excel. You see, if the gene Septin 2 is entered, as it usually is, as SEPT2, Excel automatically converts it to a date, 2-Sept. This is an issue that has been known since 2004, but it keeps increasing.

This raises some questions about the usefulness of the reviewing and editorial process at major journals if they are failing to pick up errors like this. And although this is a relatively minor glitch, it also shows once again that science is not infallible, even if it is backed up by sophisticated statistical analysis and acres of figures. Garbage in, garbage out.

By the way, our deputy editor, Xavier Symons, a post-graduate student in bioethics in Melbourne, has just had an article published in the Journal of Medical Ethics on the thorny topic of conscientious objection. Congratulations, Xav!  

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Investigating IVF

From an ethical point of view, IVF is made of teflon. Just about nothing sticks. It's understandable, since its product line is the joyful experience of cradling a newborn baby. However, there have always been some dark clouds hanging over IVF. What works always seems to have trumped what's safe. But clinicians are beginning to realise that some IVF techniques could be responsible for serious health problems for IVF children decades later. 

As we report below, the editor of the leading journal Human Reproduction warns that changes are needed. “It’s not possible to sell a single drug on the market if you do not give the total composition of the drug, but for such an important thing as culture media, that envelopes the whole embryo, you can sell it without revealing its contents. For me, that’s unacceptable,” he says. “Compared to the rest of medicine, this is such a backward area. We can’t accept it any longer.” 

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The anguish of too few children

I must be getting old. For most of my life, I have been reading about the global need to curb births and the unmet demand for contraception. And then I opened this week’s edition of The Economist and discovered that the main problem facing couples is the unmet demand for children.

The Economist surveyed 19 countries, asking people how many children they wanted and how many they expected to have. The results were astonishing.

“For more and more couples, the greatest source of anguish is that they have fewer children than they want, or none at all. … In every rich country we surveyed, couples expect to be less fertile than they would like, and many in developing countries suffer the same sorrow….

“The pain of having no or fewer children than you desire is often extreme. It can cause depression and in poor countries can be a social catastrophe. Couples impoverish themselves pursuing ineffective treatments; women who are thought to be barren are divorced, ostracised or worse.”

I hope that executives at Marie Stopes International (see article below), the United Nations Population Fund and all the other global agencies dedicated to shrinking family sizes read The Economist’s advice:

"Governments and aid agencies have turned family planning into a wholly one-sided campaign, dedicated to minimising teenage pregnancies and unwanted births; it has come to mean family restriction. Instead, family planning ought to mean helping people to have as many, or as few, children as they want."

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